A comparative study of two methods for treating type III tibial eminence avulsion fracture in adults

Sang, Weilin; Zhu, Libo; Ma, Jinzhong; Lu, Haiming; Yu, Yinxian

doi:10.1007/s00167-011-1760-1

Cited by 8 publications

(9 citation statements)

References 26 publications

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“…The remaining 13 studies assessed the outcomes of operatively treated fractures only (►Table 1). 2,3,9,10,13,18,19,[21][22][23][24][25][26][27][28][29] A total of 308 knees were included in the analysis, 20 nonoperatively treated and 288 operatively treated. The minimum follow-up ranged from 2 to 12 years (pooled mean follow-up 35 months).…”

Section: Operative Versus Nonoperative Treatmentmentioning

confidence: 99%

Treatment of Tibial Eminence Fractures: A Systematic Review

et al. 2014

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Fractures of the tibial eminence are rare, accounting for less than 1% of the injuries involving the anterior cruciate ligament (ACL). Most agree that nondisplaced fractures can be managed nonoperatively, but debate exists over the ideal treatment of displaced fractures. This systematic review evaluates the outcome of nonoperatively and operatively managed displaced tibial eminence fractures. The PubMed, Embase, and Cochrane databases were queried. Inclusion criteria included reported outcomes of displaced tibial eminence fractures, minimum 2-year follow-up, and English language. Outcomes reported were pooled and included the following: clinical instability (Lachman/anterior drawer, pivot shift, and KT 1000), patient-reported pain and/or instability, return to sport, Lysholm, Tegner, and the need for ACL reconstruction. Comparison was made in the outcomes of nonoperatively and operatively treated fractures and between suture and screw fixation techniques. Overall 16 studies met the inclusion criteria. The pooled mean age was 23 years and mean follow-up was 35 months. Clinical instability was seen in 70% of nonoperatively treated patients and 14% of operatively treated patients (p < 0.0001). Patient-reported instability was higher in nonoperatively treated patients (54 vs. 1.2%, p < 0.0001), as was the rate of ACL reconstruction (10 vs. 1.0%, p = 0.036). In comparing suture fixation to screw fixation, patient-reported instability and the rate of ACL reconstruction were equivalent. Patients treated with screw fixation had a higher incidence of clinically measured instability (Lachman and KT arthrometer) and an increased rate of hardware removal (3.9 vs. 64.9%, p < 0.05). Surgically managed patients report less instability, are higher functioning, and require fewer ACL reconstructions when compared with nonoperatively treated patients. Suture fixation was associated with improvements in clinical measures of stability and decreased need for hardware removal; however, patient perception of stability and need for ACL reconstruction was no different between the two treatment methods.

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Section: Operative Versus Nonoperative Treatmentmentioning

confidence: 99%

Treatment of Tibial Eminence Fractures: A Systematic Review

et al. 2014

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“…This recommendation contrasts with the regimen of moving the knee immediately after surgery to avoid joint fibrosis, which has been used in other studies [ 32 ]. All 3 patients with asymptomatic grade II laxity in our study were satisfied with their clinical results [ 5 , 7 ]. Furthermore, no significant difference in the functional scores or the improvement of them was found between the 2 groups.…”

Section: Discussionmentioning

confidence: 91%

“…These injuries often occur during sports participation [ 2 , 3 ], and the most frequent mechanisms are direct injury or deceleration [ 4 ]. Without stable fixation, the fractures may result in many adverse symptoms such as knee pain, instability, and limitation of the range of motion (ROM) caused by the displacement of the fracture segment [ 5 , 6 ]. Surgical fixation is suitable for type III and IV tibial eminence fractures, as well as for nonreducible type II fractures and late displacement of type I fractures based on the modified Meyers-McKeever classification [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic Fixation for Tibial Eminence Fractures: Comparison of Double-Row and Transosseous Anchor Knot Fixation Techniques with Suture Anchors

Ji¹,

Liu²,

Li³

et al. 2018

Med Sci Monit

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BackgroundTibial eminence fractures often occur during sports participation, but the optimum choice of technique for treatment is still controversial. The aim of the current work was to compare the clinical outcomes of 2 new arthroscopic anchor fixation techniques for tibial eminence fracture.Material/MethodsWe included 72 isolated tibial eminence fracture patients treated at our hospital from October 2010 to August 2015; 37 patients received the classic double-row (DR) suture anchor fixation technique and 35 received the transosseous anchor knot (TAK) fixation under arthroscopy. The clinical efficacies of the 2 techniques were assessed by radiographs, Lysholm score, and International Knee Documentation Committee (IKDC) score in follow-ups.ResultsPatients were followed for 37.6 months (range, 18–54 months). There was no significant difference of the operative time between groups (P=0.169). Postoperative radiographs of all patients showed accurate reduction and fracture healing within 3 months. Lysholm and IKDC scores improved significantly compared with preoperative scores (P<0.001). However, no significant difference in the knee range of motion or improvement of Lysholm and IKDC scores was found between groups (P>0.05).ConclusionsThe DR and TAK techniques provide precise reduction and stable fixation methods for treating tibial eminence fractures, and the clinical outcomes of the 2 arthroscopic techniques with suture anchors are satisfactory.

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“…This stimulated the emergence of arthroscopic procedures. In the literature, several studies have reported arthroscopic treatment of displaced tibial intercondylar eminence fractures 8910111213. Nevertheless, arthroscopic treatment with cannulated screws or pull out sutures may be responsible for mechanical complications especially secondary displacement 16171819…”

Section: Discussionmentioning

confidence: 99%

“…However, most techniques were related to several complications such as implant breakage, loosening or migration, infection and nonunion 6. Recently, arthroscopic techniques have been successfully proposed to decrease arthrotomy induced morbidity and improve functional outcome such as percutaneous crossed pin fixation, metal screws fixation, staple fixation and suture fixation 789101112131415. Most of them are technically demanding and require hardware removal.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic treatment of displaced tibial eminence fractures using a suspensory fixation

Loriaut

Moreau

Loriaut

et al. 2017

IJOO

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Background:Avulsion fractures of the tibial intercondylar eminence are fairly common injuries requiring surgery for the optimal functional outcome. The purpose of this study was to assess the clinical and radiological outcomes of an arthroscopic treatment of displaced tibial intercondylar eminence fractures using a suspensory device.Material and Methods:Five patients with type 2 and 3 displaced tibial intercondylar eminence fractures who received an arthroscopically assisted fixation using a double button device were enrolled from 2011 to 2012. Clinical assessment included the patient demographics, cause of injury, the delay before surgery, time for surgery, time to return to work and sport, the International Knee Documentation Committee (IKDC) and Lysholm knee scores. Stability was measured with the KT-2000 arthrometer with a force of 134 N. A side to side difference on the KT-2000 examination superior to 3 mm was considered as a significant and abnormal increase in the anterior translation. Radiological examination consisted of anteroposterior and lateral radiographs, as well as computed tomography (CT) scan of the affected knee. Clinical and radiological followup was done at 1, 2, 3, 6, and 12 months postoperatively and at final followup. CT-scan was performed before surgery and at 3 months followup.Results:The median age of patients was 31 years. Mean followup was 27 ± 5.1 months. The average delay before surgery was 3 days. At final followup, the mean IKDC and Lysholm knee scores were, 93.9 and 94.5 respectively. All patients had a complete functional recovery and were able to return to work and to resume their sport activities. No secondary surgeries were required to remove hardware. No complication was noted. Bony union was achieved in all patients.Conclusion:The arthroscopic treatment of displaced tibial intercondylar eminence fractures using a suspensory system provided a satisfactory clinical and radiological outcome at a followup of 2 years.

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A comparative study of two methods for treating type III tibial eminence avulsion fracture in adults

Abstract: IV.

Cited by 8 publications

References 26 publications

Treatment of Tibial Eminence Fractures: A Systematic Review

Treatment of Tibial Eminence Fractures: A Systematic Review

Arthroscopic Fixation for Tibial Eminence Fractures: Comparison of Double-Row and Transosseous Anchor Knot Fixation Techniques with Suture Anchors

Arthroscopic treatment of displaced tibial eminence fractures using a suspensory fixation

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